Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei City 10617, Taiwan.
Department of Laboratory Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Taipei City 10002, Taiwan.
Sci Rep. 2017 Jan 11;7:40521. doi: 10.1038/srep40521.
Urinary sediment is used to evaluate patients with possible urinary tract diseases. Currently, numerous protocols are applied to detect dysmorphic red blood cells (RBCs) and renal tubular epithelial cells (RTECs) in urinary sediment. However, distinct protocols are used by nephrologists and medical technologists for specimen concentration and observation, which leads to major discrepancies in the differential counts of formed elements such as dysmorphic RBCs and RTECs and might interfere with an accurate clinical diagnosis. To resolve these problems, we first tested a modified urinalysis protocol with an increased relative centrifuge force and concentration factor in 20 biopsy-confirmed glomerulonephritis patients with haematuria. We successfully improved the recovery ratio of dysmorphic RBCs in clinical specimens from 34.7% to 42.0% (P < 0.001). Furthermore, we confirmed the correlation between counts by the modified urinary protocol and Sysmex UF-1000i urinary flow cytometer (r ≥ 0.898, P < 0.001). A total of 28 types of isomorphic and dysmorphic RBCs were detected using a bright field microscope, with results comparable to those using a standard phase contrast microscope. Finally, we applied Sternheimer stain to enhance the contrast of RTECs in the urinary sediments. We concluded that this modified urinalysis protocol significantly enhanced the quality of urinalysis.
尿沉渣用于评估可能患有尿路疾病的患者。目前，有许多方案用于检测尿沉渣中的变形红细胞（RBC）和肾小管上皮细胞（RTEC）。然而，肾病学家和医学技术人员使用不同的方案来浓缩和观察标本，这导致对变形 RBC 和 RTEC 等有形成分的差异计数存在很大差异，可能会影响准确的临床诊断。为了解决这些问题，我们首先在 20 例血尿活检证实的肾小球肾炎患者中测试了一种改良的尿液分析方案，该方案增加了相对离心力和浓缩倍数。我们成功地将临床标本中畸形 RBC 的回收率从 34.7%提高到 42.0%（P<0.001）。此外，我们还证实了改良尿液方案与 Sysmex UF-1000i 尿液流式细胞仪之间的计数相关性（r≥0.898，P<0.001）。使用明场显微镜检测到 28 种同形和畸形 RBC，结果与使用标准相差显微镜相当。最后，我们应用 Sternheimer 染色来增强尿沉渣中 RTEC 的对比度。我们得出结论，这种改良的尿液分析方案显著提高了尿液分析的质量。
